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NPI Code Detail

MEDICARE: ANDREW C FLORES LAT, ATC

MEDICARE:   ANDREW C FLORES  LAT, ATC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
22255A2300XAthletic Trainer

General Provider Information

NPI Number : 1346725801
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW C FLORES LAT, ATC
Provider Business Mailing Address
First Line : 2863 LAKE VALLEY AVE
Second Line :
City : LAS CRUCES
State : NM
Zip : 88007-1908
Country : US
Telephone Number : 575-636-3101
Fax Number :
Provider Business Practice Location Address
First Line : 2863 LAKE VALLEY AVE
Second Line :
City : LAS CRUCES
State : NM
Zip : 88007-1908
Country : US
Telephone Number : 575-636-3101
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2018
Last Update Date : 11/07/2023

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Directions to “ ANDREW C FLORES LAT, ATC” Practice Location

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